Use of mid-upper arm circumference in determining undernutrition and illness in rural adult Oraon men of Gumla District, Jharkhand, India

Introduction: Body mass index (BMI) is widely accepted as one of the best indicators of nutritional status in adults. Mid-upper arm circumference (MUAC) is another anthropometric measure that has also been used to evaluate adult nutritional status. The objective of this study was to evaluate the use of MUAC as a simpler and reliable alternative to BMI. A suitable cut-off value was also proposed for identification of chronic energy deficiency (CED) in relation to self-reported illness among the adult Oraon males of Jharkhand state in India. Methods: The study was based on a cross-sectional survey involving 205 rural adult men belonging to the Oraon tribal group of Jharkand State in India. Height and weight were measured for each participant. The BMI was calculated as kg/m(2). The internationally accepted cut-off points of BMI and MUAC were utilised to determine nutritional status. An episode of illness was recorded for each subject if any working day was lost. Receiver operating characteristic curve analyses were undertaken to discover the most suitable values of MUAC both for CED and illness. Results: The MUAC values of 243 and 239 mm were identified as the best cut offs to identify CED (BMI <18.5) and illness, respectively. There were marked increases in both CED and illness prevalence rates at a MUAC level lower than 240 mm. Therefore, a MUAC value of close to 240 mm seemed appropriate as a simple and efficient cut-off point for the determination of undernutrition and higher rates of illness and loss of working days in adult Oraon males. Conclusion: Because MUAC is a much simpler measure than BMI, the use of MUAC 240 mm as a cut-off point is predicted to have considerable public health implications, especially with respect to primary health care related to CED and morbidity.